Fungal skin disease in children is a heterogeneous group of lesions of the skin, agents that are pathogenic microscopic fungi. Fungal diseases of the skin in children can cause peeling, itching, cracks in skin; loss of hair, loss of nails. Diagnosis of fungal skin disease in children includes an overview, fluorescent testing, microscopy and culture of scrapings of the gut flora. A comprehensive treatment of fungal skin diseases in children are performed with the use of external and systemic antifungal agent, desensitizing and corticosteroid drugs, Immunostimulants, physiotherapy.
Fungal diseases of the skin in children are developing at defeat smooth the skin and its appendages (hair and nails) of parasitic fungi. In dermatology, the share of fungal infections account for 37-40% of all skin diseases. There is a tendency that the growth in the number of children with fungal skin disease developed in parallel with other dermatoses atopic dermatitis, eczema, psoriasis, pyoderma. The danger of fungal diseases of the skin, which is toxic and the sensitizing action of fungi on the child's body, which triggers the development of allergic reactions, weakened immunity, the burden of chronic diseases.
At the depth of the defeat of fungal diseases of the skin in children are divided into keratomycosis (pityriasis versicolor), dermatofitia (microsporia, trichophytosis, favus, epidermophytia, rubromycosis); candidiasis; deep mycoses.
Keratomycosis are characterized by lesions of the Horny layer of the epidermis, without the development of inflammatory reactions, damage to hair and nails. Dermatofitia accompanied by a weak or a strong inflammatory changes in the skin in the epidermis, damage of hair and nails. Dermatophytes (the fungi from the genera Trichophyton, Microsporum, Epidermophyton) are the main causative agents of fungal skin disease in children. Superficial candidiasis – the second most common detection among the fungal diseases of the skin in children, caused by the pathogenic fungus from the genus Candida (usually C. albicans) affecting skin and mucous membranes.
The prevalence of dermatomycosis among all the fungal diseases due to the constant close contact of the skin with the environment. The causative factors of fungal diseases of the skin in children is often distributed in nature, have a lot of different and high resistance to external factors. Fungal diseases of the skin in children are generally observed in the form of sporadic cases, outbreaks, which are more characteristic of dermatophyte scalp.
A source of anthropophilic dermatomycosis is a sick man, zoophilic (microsporia) - sick animals (stray cats and dogs, cows, horses), a rare geophysical – ground. Infection occurs by direct contact of the child with skin and hair of the patient or through everyday objects, fungi and their spores (towels, washcloths, combs, toys, caps, shoes). Often fungal diseases of the skin of children infected in swimming pools, showers and baths, on the beach, in hairdressing salons, which are organised children's groups.
Characteristics of children's skin (hydrophilicity, increased vascularization, reduced bactericidal activity of sweat and sebaceous glands, easy vulnerability), immaturity of the immune system to facilitate the penetration of the pathogen in the epidermis, which contribute to the rapid development of fungal diseases in children.
The reduction of protective forces of an organism of the child can be triggered by poor ecology, stress, prolonged use of antibiotics and chronic infections. With a weak immune system opportunistic fungi that live in the norm on the baby's skin can transform into a pathogenic form and cause fungal diseases (e.g. Malassezia furfur is the causative agent of multi-colored lichen).
The type and severity of symptoms of fungal diseases of the skin in children are dependent on the type and virulence of the pathogen, localization, and lesion size, the speed of reaction of the organism. Fungal infections of the skin in children the most common and most contagious are microsporia and trichophytosis (ringworm), occurring with a primary lesion of the smooth skin and scalp.
microsporia in most cases (99%) is called the zooantropophilic fungus Microsporum canis, rarely anthropophilic M. ferrugeneum. This happens, usually children of preschool and younger school age, continues with the formation of small, round, well-defined lesions. In the lesion of the skin that is covered with small grey-white spots. On the smooth skin microsporia shows concentric erythematous-squamous plate, which is surrounded with a cushion of small blisters and scabs.
In children of early age often indicated for superficial trichophytosis of the scalp, caused by trichophytons anthropophilic (Trichophyton tonsurans and T. violaceum), coupled with the loss of the color, elasticity and Shine to hair, the creation of clear, covered with small items. Clinical signs of trichophytosis smooth skin similar symptoms microsporia. For the infiltrative-suppurating forms, characteristic of perifolliculitis and deep follicular abscesses.
Pityriasis versicolor is seen in young children; characterized by the appearance of the skin on the back and chest cream, light brown or yellow-pink dots of irregular shape, prone to peripheral growth. The disease is slightly contagious, is a chronic course; the affected skin does not tan (secondary leukoderma).
With the defeat of the fungus Achorion schonleini developed a rare fungal skin disease in children - favus (ringworm) usually occurs on the scalp, the formation of sculling - a dry, thick crust with a yellow or light brown, with raised edges and the center, publishes a stagnant smell. The impact of the fungus of the hair, become like tow. Favus can result in a solid scar with skin atrophy and loss of hair follicles.
Rubromycosis due to anthropophilic pathogen T. rubrum, occurs in children aged 7-15 years; it would seem, dry skin of the feet and palms, clear, pink-red, in small pockets with scalloped-edge; damage to the nail.
When epidermophytia in wrinkles and on the soles of the feet, there is a slight redness, peeling, cracks, and bubbles, hyperkeratosis along with itching.
For various types of onychomycosis is characterized by thickening, modifying shape and color of the nail plate from its gradual destruction, onycholysis, damage to the nail shaft.
Candidiasis in children is most often manifested by thrush - a white coating on the tongue, gums, cheeks. Vesicular rash and extensive superficial ulceration, accompanied by itching and burning, can also occur in the natural skin folds.
After suffering a fungal disease of the skin in children occurs are not immune and can be re-infected with the same species of mushrooms.
For the identification of fungal diseases of the skin requires a comprehensive examination of the child in a children's dermatologist.
Microscopy of a clinical material (hair, flakes of epidermis, the Horny mass from the nail bed) allows to detect the presence of mycelium, hyphae, or spores, to confirm, a fungal infection of the skin in children and to determine its tissue form. Sowing scrape on universal and selective media help to distinguish the pure culture of the fungus and determine their drug sensitivity; bacterioscopy of smears of the cultures and biochemical analysis, – to conduct the phenotypic identification of the causative agent.
Review of the baby's skin under a wood's lamp reveals a Golden-yellow glow scales with multi-colored lichens, bright green - when microsporia, weak-with the defeat of the trichophytons.
Fungal diseases of the skin in children should be distinguished from dermatitis with similar manifestations: psoriasis, neurodermatitis, eczema, erythrasms, vitiligo, seborrhea, syphilitic leukoderma, etc
The treatment of fungal skin diseases in children in the ambulatory and in the absence of the effect, the presence of comorbidity and severe - in the specialized hospital. In the treatment of fungal skin diseases in children, using monotherapy or a combination of external and systemic antimycotic means, antihistamine and glucocorticoid drugs, immunostimulants, multivitamins, physiotherapy.
Perform daily processing of skin lesions with antiseptic solutions (furatsilina, potassium permanganate, boric acid); treatment that is performed and the stop plate of the nail; hair in the lesion is removed, remove the cover.
In fungal infections of the skin, wrinkles, hands and feet in children using antifungal pastes, ointments, creams, emulsions with terbinafine, naftifin, clotrimazole, miconazole, ketoconazole; sulfur-tar, salicylic, naphthalane ointments. When joining a bacterial infection prescribe antimycotic ointments containing antibiotics and corticosteroids. In severe and widespread dermatophytics, lose hair and nails in addition to shows that receiving systemic antimycotics (griseofulvin, Itraconazole, fluconazole). If necessary, the treatment of fungal infections of the skin and nails, surgical removal of the nail plate.
Natural treatment fungal skin diseases in children include medicinal electrophoresis, pulsed magnetotherapy, darsonvalization, UHF-therapy.
The treatment of fungal skin diseases in children is long and continues until resolution of the clinical manifestations and negative control tests on the fungus.
Fungal diseases of the skin in children are persistent and, of course, require long-term systematic treatment, but with strict observance of the recommendations have a favourable prognosis. Fungal diseases of the skin in children become chronic recurrent form and can continue into adulthood.
Prevent the spread of fungal diseases of the skin in children includes quarantine measures in institutions; disinfection of premises, household items, clothing, shoes, manicure and hairdressing supplies; the elimination of the contact of the child with the animals, the observance of rules of personal hygiene, the proper care of the skin, normalization of immunity.